Clinical Experience With Automated Percutaneous Lumbar Discectomy

Gw, Davis; Onik, Gary

doi:10.1097/00003086-198901000-00014

Cited by 55 publications

(10 citation statements)

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“…However, this is a decompressive type of procedure, applied without direct exposure of the pathological structures. Therefore, the removal of disc fragments which are not continuous with the disc space is not possible [9,10,15,16,21,22,27]. On the other hand, the amount of disc material which should be removed in order to provide symptomatic relief is not known exactly [25].…”

Section: Discussionmentioning

confidence: 99%

Effect of Nd?YAG laser on experimental disc degeneration part II. Histological and MR imaging findings

et al. 1996

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The potential advantages of percutaneous procedures over traditional discectomy are multiple, but the use of laser energy to ablate disc tissue appears entirely empirical. To date, no experimental study exists investigating the results of laser on degenerated intervertebral disc. The present study was therefore undertaken to determine the histological and radiological changes induced by neodymium-yttrium-aluminum-garnet (Nd:YAG) laser on such disc tissue. It was shown that the vaporization of disc tissue was caused by Nd:YAG laser in early period, but this was gradually replaced by cartilaginous fibrous tissue at 60 days after laser irradiation as a result of the proliferation of cartilaginous cells and fibrous tissues. Accordingly the magnetic resonance (MR) imaging index histogram moved to the left in the early period, but it moved to the right again at 60 days after laser irradiation. In view of these data, we conclude that the use of laser in degenerated disc disease does not represent an effective treatment as an alternative to conventional surgical methods.

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Section: Discussionmentioning

confidence: 99%

Effect of Nd?YAG laser on experimental disc degeneration part II. Histological and MR imaging findings

et al. 1996

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“…Success rates reported in the literature range from 77.5 to 87% and the complication rate is 1%. 12,13,45,59 To date, however, there have been no prospective randomized controlled studies to validate the long-term outcomes of PLD.…”

Section: Percutaneous Lumbar Discectomymentioning

confidence: 99%

Minimally invasive spinal surgery: a historical perspective

Thongtrangan¹,

Le²,

Park³

et al. 2004

FOC

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The concept of minimally invasive spinal surgery embodies the goal of achieving clinical outcomes comparable to those of conventional open surgery, while minimizing the risk of iatrogenic injury that may be incurred during the exposure process. The development of microscopy, laser technology, endoscopy, and video and image guidance systems provided the foundation on which minimally invasive spinal surgery is based. Minimally invasive treatments have been undertaken in all areas of the spinal axis since the 20th century. Lumbar disc disease has been treated using chemonucleolysis, percutaneous discectomy, laser discectomy, intradiscal thermoablation, and minimally invasive microdiscectomy techniques. The initial use of thoracoscopy for thoracic discs and tumor biopsies has expanded to include deformity correction, sympathectomy, vertebrectomy with reconstruction and instrumentation, and resection of paraspinal neurogenic tumors. Laparoscopic techniques, such as those used for appendectomy or cholecystectomy by general surgeons, have evolved into procedures performed by spinal surgeons for anterior lumbar discectomy and fusion. Image-guided systems have been adapted to facilitate pedicle screw placement with increased accuracy. Over the past decade, minimally invasive treatment of cervical spinal disorders has become feasible by applying technologies similar to those developed for the thoracic and lumbar spine. Endoscope-assisted transoral surgery, cervical lam-inectomy, discectomy, and foraminotomy all represent the continual evolution of minimally invasive spinal surgery. Further improvement in optics and imaging resources, development of biological agents, and introduction of instrumentation systems designed for minimally invasive procedures will inevitably lead to further applications in minimally invasive spine surgery.

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“…It is postulated that due to vaporization of water, internal disc pressure decreases which in turn results in disc decompression as well as decompression of neighbouring neural elements [13,24,32,36,44,45]. This type of disc surgery showed some technical difficulties, such as causing damage to the surrounding tissues by the laser energy [13,[15][16][17]25].…”

Section: Introductionmentioning

confidence: 99%

Effect of Nd?YAG laser on experimental disc degeneration part I. Biochemical and radiographical analysis

et al. 1996

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Intervertebral disc herniation is an important health problem from both the social and economic aspect. It is often accompanied by a decrease in the content of water and proteoglycan (PG). The present study was undertaken to elucidate the effect of neodymium-yttrium-aluminum-garnet (Nd:YAG) laser on degenerated disc tissue. In this study a ventral disc herniation model in guinea pigs was performed to study the effects of ND:YAG laser on degenerated disc with low water and PG content. Effect of ND:YAG laser on degenerated cervical disc tissue is examined from the aspects of biochemistry and radiology. In the acute period water, PG, and collagen content decreased due to the ablative effect of ND:YAG laser on disc tissue. When changes in the degenerated disc in the post-laser chronic period were compared with degenerated disc findings, statistically significant changes could not be be found. From the results of this study, there is no question that the Nd:YAG laser offers many potential benefits, it remains to be proven whether or not this is of real benefit in the treatment of patients with degenerated disc disease.

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Clinical Experience With Automated Percutaneous Lumbar Discectomy

Cited by 55 publications

References 0 publications

Effect of Nd?YAG laser on experimental disc degeneration part II. Histological and MR imaging findings

Effect of Nd?YAG laser on experimental disc degeneration part II. Histological and MR imaging findings

Minimally invasive spinal surgery: a historical perspective

Effect of Nd?YAG laser on experimental disc degeneration part I. Biochemical and radiographical analysis

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